Print and mail to the address below or download as a Word document Motorcycle Riders Memorial of Illinois Lifetime Membership Application Membership: 10.00, Patch: 10.00 Please Print Clearly Name______________________________ Address_____________________________ City_____________State___Zip Code______ In signing I understand and acknowledge that this fee is a one-time membership fee and agree to follow the bylaws and rules of the Motorcycle Riders Memorial of Illinois Organization. Signed:______________________________ Application taken by:____________________ Receipt Application Taken By:___________________ Amount Paid_____ Mail to: MRM PO Box 1285 Benton, IL 62812